Styptic bandage



Dec. 10, 1963 J. 5. ROBINS 3,113,568

STYPTIC BANDAGE 2 Sheets-Sheet '1 7 Filed Dec. 26, 1961 INVENTOR.

John S. Robins BY WHJIKEHEAD, VOGL a LOWE Pan 7M ATTORNEYS Dec. 10, 1963J. s. ROBINS 3, 3,568

. STYPTIC BANDAGE Filed Dec. 26, 1961 2 Sheets-Sheet 2 IN V EN TOR.

John S. Robins BY WHITEHEAD', VOGL a LOWE ATTORNEYS 3,113,568 STYPTIQBANDAGE John S. Robins, 600 Gaylord, Denver 6, Colo., assignor ofone-half to Eric K. Erskine, Qhicago, Ill. Filed Dec. 26, 1961, Ser. No.162,062 9 Claims. (Cl. 128-156) This invention relates to bandages andmore particularly to bandages for open Wounds to cover and protect thesame and especially to facilitate the stanching of bleeding; a primaryobject of the invention being to provide a novel and improvedconstruction of a bandage which is especially adapted to initiate,engender and procure hemostasis. As such, the invention will behereinafter described and referred to as a styptic bandage although itis to be understood that the utility of the bandage is not restricted tothis preferred use.

Except in the case of severe Wounds, as where arteries are severed,hemostasis will normally occur spontaneously by blood clotting althoughexternal agencies such as styptics may be used to facilitate suchaction. The easily observable phenomenon of blood clotting occursthrough a complex interaction of fluid and discrete constitutents of theblood, which is as yet not fully understood. However, if a drop offreshly drawn blood is placed upon a slide and observed with amicroscope, it will be found that delicate threads, or fibrils, areformed throughout the whole drop and a meshwork of these fibrilscntangles the red blood corpuscles and encloses the liquid part of theblood. With larger amounts of blood, as in a container, or in a Woundcavity, the whole amount becomes jellylike and clings to the walls ofthe container. Soon the jellylike mass begins to shrink and as theshrinkage continues, to press out of the mass a yellowish liquidcomponent called the serum. Once a clot, formed in this manner, hasdried and hardened over a wound, it is most effective in protecting andpermitting healing of the wound.

The coagulating-producing fibrils consist of a protein known as fibrinwhich does not initally exist in the blood when flowing through theveins and arteries of an individual, but is a substance produced fromthe activity of an agent which comes into being on leaving theenvironment of the blood vessels. It is believed that the blood normallycontains at least five ingredients con cerned in coagulation. Certain ofthese ingredients are found in the plasma and other ingredients in theplatelets or thrombocytes. These platelets, normally corpuscularelements, appear to trigger the coagulation action by breaking up andreleasing a substance called thromboplastin. They are generally regardedas spherical or oval bodies approximately 3 micrornillimeters indiameter. On leaving the blood vessels, they rapidly agglutinate, orclump, and break to pieces to initiate a slow chain reaction With theother ingredients and in normal blood, full coagulation will occur inabout 2 /2 minutes.

Without detailed explanation, it is thus apparent that an action whichbreaks up the platelets, or more effectively does so in a controlledmanner will hasten or control the clotting actions which stanchbleeding. For example, it is well known that contact of the blood with arough surface such as a towel or piece of bandage will assist in this.Stanching the flow of blood is therefore an important function of anordinary cloth or padded bandage.

To better appreciate the present invention, an improved styptic bandage,it is necessary to point out certain limitations of ordinary bandageswhen used for this purpose. In the first place, the blood tends to flowpast the fibres of an ordinary bandage and into the bandage itselfwithout any significant coagulation commencing until all, or at least asubstantial part of the bandage is soaked with blood. Next, aftercoagulation occurs and a clot is formed the capacity of the bandage tosoak up the serum is limited, especially when the bandage is previouslysoaked with blood, and often to the point where excess serum whichcannot be effectively removed by soaking into the bandage may prevent aclot from completely closing a wound. Finally, after the clot is formedand set, it is also set in the bandage to the point where it is next toimpossible to remove the bandage without tearing the clot from the woundto initiate more bleeding and exposing the open wound to contamination.

Such undesirable features in a bandage have been long recognized andheretofore efforts have been made to separate the bandage from thefinally-formed clot as by using a thin plastic membrane between thewound and the absorptive padding of the bandage, with absorption beingeffected as with flaps or gates cut in the membrane. A membranefacilitates the removal of a bandage from a wound, but limits theabsorptive power of the padding element. Moreover, by its very nature, amembrane sur face will not especially accelerate breaking up andagglutination of the platelet constituents of the blood. While thebreaking up and agglutination of the platelets is accelerated by contactwith foreign surfaces, the acceleration is roughly proportional to thearea of the surface of contact and a rough absorptive material such asgauze presents a far greater effective contact surface than does asmooth non-absorptive membrane surface. Clot formation at the wound isimpeded by a non-absorptive membrane surface.

The present invention was conceived and developed with the above factorsin view and comprises, in essence, an improved construction of a stypticbandage which is formed by facing an absorptive pad with a closely-knit,reticulated barrier characterized by the property of permitting andfacilitating the passage of liquid and serum components of bloodtherethrough and into the absorptive pad and, and the same time, causingagglutination of the platelets and the subsequent formation of fibrin atthe face thereof.

It follows that a further object of the invention is to provide a noveland improved styptic bandage which is especially adapted to initiateclot formation at the contact surface of the bandage and to accelerateand control the formation of a clot over a bleeding cut or like wound.

A further object of the invention is to provide a novel and improvedbandage having a reticulated barrier at the face of the bandage whichfacilitates the formation of a clot at this face and which furtherestablishes a plane of weakness at the barrier to permit easy removal ofthe bandage from the clot without tearing the clot from the wound.

A further object of the invention is to provide in a bandage a novel andimproved reticulated barrier at the face of the bandage which isconveniently and economlcal- 1y formed with an open-cell, plastic foammaterial.

Further objects of the invention are to provide a novel and improvedbandage having a resilient, foam-like reticulated barrier at the face ofthe bandage which is soft to the touch, will not irritate open tissue,is non-toxic, and may be easily sterilized in any ordinary manner.

Further objects of the invention are to provide a novel and improvedstyptic-type bandage which is a low-cost, neat-appearing, versatile andreliable product.

With the foregoing and other objects in view, all of which more fullyhereinafter appear, my invention comprises certain novel and improvedconstructions, combinations, and arrangements of parts and elements ashereinafter described, defined in the appended claims and illustrated inthe accompanying drawing which- FIG. 1 is an isometric View of the upperside of a patch bandage constructed according to the principles of myinvention.

FIG. 2 is an enlarged isometric view of the underside of the patchbandage illustrated at FIG. 1.

FIG. 3 is a transverse section as taken from the indicated line 3-3 atFIG. 1, but on a further enlarged scale.

FIG. 4 is a greatly enlarged fragmentary sectional portion of thebandage as taken from the indicated line 4-4 at FIG. 3.

FIG. 5 is a further enlarged view of a single cell of one componentportion of the invention.

FIG. 6 is a transverse sectional view of a portion of the bandage,similar to FIG. 4, and diagrammatically illustrating the bandage ascovering a fresh wound, with arrows indicating blood and plasma flow.

FIG. 7 is a diagrammatic view similar to FIG. 6 but showing the mannerin which the bandage may be pulled away from a clot-filled wound andseparated from the blood clot.

FIG. 8 is a fragmentary perspective sketch of the underside of anothertype of bandage, embodying the principles of my invention and withportions of under layers being removed to better illustrate theconstruction thereof.

Referring more particularly to the drawing, my invention may be embodiedin a typical patch bandage 10, as illustrated at FIGS. 1 and 2, and itwill be hereinafter described as such. The typical patch bandage 10 ischaracterized by an absorbent fiber pad 11 which is backed up by andlocated at the center of a holding strip 12,, the strip 12 having anadhesive surface 13 with the pad 11 being affixed to this surface. Thebandage may be placed over a. minor cut or wound to cover the Wound withthe pad covering the wound to permit the pad to absorb the blood flowtherefrom and topermit the adhesive surface 13 of the strip 12 to adhereto the skin of the patient at each side of the pad and hold the bandagein place. Suitable holes 14 are cut in this back-up strip at the pad toprovide for ventilation of the pad and to permit a drop'of liquid, suchas an antiseptic, to be soaked into the pad after it is set, wheneverthis is desired. This bandage may be provided commercially in a closedsterile bag or container or the like, and it may include a removableprotective waxpaper cover at its face; however, such features need notbe considered herein since they are not concerned with the invention.

My invention contemplates the use of a firmly knit, reticulatedforaminiferous barrier 2%) at the face of the pad 11 which is capable offacilitating coagulation of the blood by permitting certain constituentsto pass through the barrier and retarding and inhibiting the passage ofother constituents of the blood and especially engendering the formationof fibrin in the barrier 20.

It was discovered that this barrier could be formed of certain types ofopen-cell plastic foams which may be produced from resins such aspolyurethane, polyether, and polyvinyl chloride and even from some typeof elastomers, including natural rubber. However, it is to be recognizedthat where a plastic material capable of forming an opencell foam isselected to serve as a barrier 20, it must not "only have properties ofbeing non-toxic and stable, it should also have a melting point ofsoftening point which is sufliciently high to resist the temperaturesencountered in an autoclave or like apparatus in which the bandage isapt to be placed for sterilization prior to packaging it.

Polyurethane foam was found to be especially suitable for this purposeand the invention will be described with respect to a barrier formed bythis particular open-cell foam material, although it is to be understoodthat other materials, such as those above mentioned, can be used. "Inthe manufacture of polyurethane foam, the size of foam cells may beeasily controlled and it is possible to obtain foam having a very small:cell structure. The cell form of this foam is generally constant,regardless of size, and when magnified as illustrated at FIG. 5, asingle cell 21 appears to be in the general shape of a twelve orfourteen sided figure, of a type characteristic of the geometric formoften assumed by a bubble in a mass of foamed substance. In thisopen-cell foam, each face 22 of the cell 21 is similar to an open, fiveor six-sided window frame with strands or minute bars of polyurethaneforming leglike links 23 which are arranged in a five-sided pattern ateach facial surface 22 of the cell. Polyurethane is a very tough andresilient material and the cells 21 may be of extremely minute portionsWithout impairing their strength or elasticity.

It is contemplated that the individual cells of the foam suitable forthe purpose at hand will be in the range of one-half millimeter indiameter, or less. However, it is to be recognized that such is anaverage value, for the size of the cells will vary in a sheet of foam.With such material, the minute, rod-like interconnecting links form anextremely fine meshwork which is capable of providing ideal surfaces forinitiating the formation of fibrin in the blood.

Such a foam material for the barrier 20 may be manufactured according toany conventional practice to provide a thin layer of material having aselected normal pore or cell size. A preferred method of manufacturingthe barrier material is to provide blocks of foam which are then slicedinto very thin layers or sheets. The thickness of each sheet is such asto provide a reticulated barrier and a preferred thickness of thebarrier is approximately one millimeter or slightly less, which is withpores having a normal pore or cell size of one-half millimeter,sufiicient to encompass a thickness of approximately two layers of cells21. This delicate, thin layer of material is translucent and almosttransparent. Nevertheless, it forms a myriad of irregular passages whichare interrupted by the irregular spacing of cell links 23 as in themanner illustrated somewhat diagrammatically at FIG. 4.

It is to be understood that while such dimensions may be preferred,other proportions of normal pore or cell size and thickness of thebarrier may be used. Also, it is to be recognized that the reticulatedbarrier 20 may be manufactured according to other methods than thoseabovedescribed. For example, a very thin layer of liquid, foam formingresin may be spread upon a non-adhesive surface and then activated tothe foamed form in a substantia-lly continuous operation.

'Inthe manufacture of a patch bandage 10 as illustrated, thepolyurethane foam barrier 20 is generally shaped as a rectangular stripto fit over the pad 11 with the strip having substantially the same'width as the pad, and having a length slightly exceeding that of thepad. Therefore, when placed over the pad 11, each end of the barrier 20will overlap the pad slightly so that a narrow edge 24 at each side ofthe pad, can be afiixed to the adhesive surface 13 to effectively holdthe barrier in place over the pad.

in the alternate form and especially where a larger bandage is used,such as the continuous bandage 10' illustrated at FIG. 8, it isdesirable to laminate the barrier 20' to the pad 11' forming thebandage. This lamination maybe accomplished in several differentmethods. A very simple method is to merely cross-stitch or spot-stitchthe barrier to the pad, as illustrated as 25 at FIG. 8. Rela=tively fewstitches will be required for this purpose, for only a very light bondwill be required between the barrier andpad to hold the barrier inplace.

Another method of connecting the barrier to the pad is to use very smallquantities of flexible adhesive, such as latex. For example, thinnedlatex may be lightly applied, as by a spray, to the contacting surfacesof both the pad '11 and the barrier .26, so that when they are pressedtogether enough adhesive action will occur to permit the thin,light-Weight barrier to adhere to the pad without impairing the porosityof either the barrier or the pad.

The use of such a bandage is diagrammatically illustrated at H68. 6 and7 where a small patch bandage is placed over a fresh wound W to stanchthe flow of blood B therefrom. The reticulated barrier 20, formed as amyriad of minute cell-shaping links 23, presents an ideal environmentfor the formation of fibrin, for each minute link of the individualcells will act as a focal point and base where the fibrin-producingsubstances will commence vto act. 'I'his accelerates the formation of ablood clot completely across the bandage. This five reticulated meshworkforms a barrier which will impede the passage of the agglutinating andsolidifying components of blood through it, although it will not at allimpede the flow of fluid components of the blood especially the serum.The result is, with normal blood, a material speeding up of theformation of a clot C covering the wound W and at the same time clotformation in the pad will be impaired because of a reduced amount offibrin-producing substances passing the barrier. The clot C in the padwill be weak and sugared in structure. Blood plasma will then movethrough the barrier 20 and into the bandage pad ll as indicated by thearrows P.

The resilient barrier of polyurethane foam will thus form a plane ofweakness through blood clot portion C and=C and permit the bandage to beeasily removed from the wound and separated from the blood clot withouttearing the clot out of the wound. This plane of weakness is especiallywell defined because the small links of polyurethane foam are in and ofthemselves non-absorbent to blood, and thus, while the cell structuresof a myriad of links effectively act upon blood as heretofore described,the individual links when disturbed in a clot of blood easily pull freeof the clot substance. All that is required is to gently stretch anddistort the edges of the barrier about the edge of the clot as at 26 inFIG. 7. This action will pull and stretch the individual cells or poresin the foam and reduce the normal transverse size of such pores so as tobreak loose fragments of the clotted blood within the pores. Thisstretching of the resilient barrier in different directions will quicklyloosen the barrier to the point where the portion of the clot within thebandage is severed from the portion Within the wound. Such an action isillustrated diagrammatically at FIG. 7 where the bandage has beenpartially removed from the wound leaving a protective blood clot C inthe wound and separating the clotted blood C in the bandage from thatremaining on the wound. The surface of the clot appears to be smooth.However, upon close examination, it will be seen that it has a roughenedcharacteristic appearance which corresponds with the surface formationof the barrier.

It is to be noted that styptic, clot-producing agents may be used incombination with this improved bandage, and small amounts of commonsubstances used for this purpose, such as alum or salts of iron and thelike, may be located in the bandage within the interstices of thebarrier 20 or at the contact surface between the barrier 20 and thebandage pad 11.

It is to be further noted that the texture of a finely fonned open-cellresilient resin such as polyurethane is very soft to the touch and suchmaterials as polyurethane are chemically inert with respect to tissue.Because of this, the bandage 10 may also be advantageously used forother purposes such as to cover and protect burns and similar woundswhere bleeding is not an important factor.

From the foregoing description of my invention, others can devisealternate and equivalent constructions which are within the spirit andscope of my invention. Therefore, my protection is to be limited only bythe proper scope of the appended claims.

I claim:

1. In a bandage having an absorbent fibrous pad and adapted for use incovering a wound from which coagulatable material is passing, theimprovement which comprises a thin reticulated foam layer superimposedon one face of said pad, said foam layer having a multiplicity of openpores therein, said foam layer being laterally stretchable to reorientand reduce the normal transverse size of the pores therein, said poreshaving a. normal size such that coagulatable material passing throughsaid foam layer toward said pad can form Within said foam layer,continuous coagulated pieces substantially only of a size which arereadily broken by lateral stretching of said foam layer whereby saidfoam layer provides a plane of weakness within a coagulated massextending from a wound into said pad.

2. The improvement defined in claim 1 wherein said foam layer comprisesa sheet of resilient synthetic resin foam of the open pore type, whereinthe thickness of the foam is approximately one millimeter, and whereinthe average pore diameter is approximately one/half millimeter.

3. The improvement defined in claim 1 wherein said foam layer comprisesa sheet of polyurethane foam.

4. The improvement defined in claim 1 wherein said foam layer comprisesa sheet of polyether foam.

5. The improvement defined in claim 1 wherein said foam layer comprisesa sheet of natural rubber latex.

6. The improvement defined in claim 1 and further including means forholding said foam layer against the face of the bandage.

7. The improvement defined in claim 1 wherein the bandage is formed as apatch bandage having an outer adhesive strip, wherein the absorbent padis a rectangular patch disposed centrally of the strip, and wherein saidfoam layer has edges overlapping the pad and being affixed to theadhesive strip at opposite sides of the pad.

8. The improvement defined in claim 1 wherein said foam layer comprisesa sheet of polyurethane foam, wherein the thickness of said sheet isapproximately one millimeter, and wherein the pores in said sheet havediameters of less than the one/ half the thickness of the sheet.

9. A method of covering a wound to induce coagulation of blood passingtherefrom and thereafter removing the covering, said method comprisingthe steps of:

(a) placing a thin flexible and stretchable reticulated foam layerpervious to at least some coagulatable layer;

(d) thereafter stretching said foarn layer laterally in differentdirections to break up continuity of coagulated blood material thereinsaid layer; and,

(e) then removing said layer and said pad from the wound.

References Cited in the file of this patent UNITED STATES PATENTS2,477,403 Brady July 26, 1949 2,858,830 Robins Nov. 4, 1958 2,888,013Levitt May 26, 1959 2,972,350 Deker Feb. 21, 1961 2,992,644 Plantinga eta1. July 18, 1961

1. IN A BANDAGE HAVING AN ABSORBENT FIBROUS PAD AND ADAPTED FOR USE INCOVERING A WOUND ROM WHICH COAGULATABLE MATERIAL IS PASSING, THEIMPROVEMENT WHICH COMPRISES A THIN RETICULATED FOAM LAYER SUPERIMPOSEDON ONE FACE OF SAID PAD, SAID FOAM LAYER HAVING A MULTIPLICITY OF OPENPORES THEREIN, SAID FOAM LAYER BEING LATERALLY STRETCHABLE TO REORIENTAND REDUCE THE NORMAL TRANSVERSE SIZE OF THE PORES THEREIN, SAID PORESHAVING A NORMAL SIZE SUCH THAT COAGULATABLE MATERIAL PASSING THROUGHSAID FOAM LAYER TOWARD SAID PAD CAN FORM WITHIN SAID FOAM LAYER,CONTINUOUS COAGULATED PIECES SUBSTANTIALLY ONLY OF A SIZE WHICH AREREADILY BROKEN BY LATERAL STRETCHING OF SAID FOAM LAYER WHEREBY SAIDFOAM LAYER PROVIDES A PLANE OF WEAKNESS WITHIN A COAGULATED MASSEXTENDING FROMA WOUND INTO SAID PAD.